- CDC issues guidelines for daycares and schools to avoid transmission of monkeypox.
- The agency advises washing hands regularly, disinfecting surfaces and shared objects, and asking children, staff and volunteers to stay home when they are sick.
- According to the CDC, the risk of children and adolescents developing monkeypox is low.
Schools, day care centers and other facilities serving children and adolescents do not need to take extra precautions against monkeypox, the Centers for Disease Control and Prevention (CDC) said.
The agency advises these facilities to “follow their daily operational guidelines that reduce the transmission of infectious diseases.”
This includes washing hands regularly, disinfecting surfaces and shared items, and asking children, staff and volunteers to stay home when they are sick.
“Currently, the risk of monkeypox for children and adolescents in the United States is low,” the CDC said on its website, along with a series of frequently asked questions.
As of August 24, more than 16,000 monkeypox infections have been reported to the CDC, with at least one case in every state and the District of Columbia.
But only a small number of cases have occurred in school-age children. CDC data released Aug. 21 showed that of the reported cases, six were in children ages 0 to 5, seven in children ages 6 to 10, and four in children ages 11 to 15.
This is based on nearly 70% of reported cases with available age data.
While “parents should be aware of monkeypox,” they shouldn’t be “overly concerned at this point,” said Dr. Amanda D. Castel, a professor in the department of epidemiology at George Washington University in Washington, DC.
Dr. Dean Blumberg, a professor in the Division of Pediatric Infectious Diseases at UC Davis Health in Sacramento, California, agreed with the CDC’s assessment of the low risk of monkeypox for children.
“[The monkeypox virus] it is not easily transmitted and there are signs that people are contagious, such as when they have a rash,” he said.
There is some new evidence that monkeypox can be spread by people who are asymptomatic, but it is unclear whether this is a common problem.
A rash is one of the most common symptoms of monkeypox. People may also have fever, chills, muscle aches or headache.
Children have similar symptoms as adults, but other conditions can cause a rash in children, such as chicken pox, measles, allergic skin reactions, and drug-related reactions.
So, “if your child has a rash, don’t panic,” Castel said. “It could be something else.”
Most cases of monkeypox in children and adolescents get better on their own without treatment, according to the CDC.
Some children are at higher risk of severe disease, including children under 8 years of age, with an immune-compromising condition, or with certain skin conditions such as eczema, severe acne, or burns.
CDC data show that during the current outbreak in the United States, most cases of monkeypox were associated with sexual contact or close intimate contact.
However, the monkeypox virus can infect anyone — including children — who has close, personal, frequent skin-to-skin contact with someone with monkeypox, the CDC said.
However, Bloomberg said it was unlikely that children would have that kind of contact in a school setting.
“Although children may walk with each other, there are very few children who will have prolonged skin-to-skin contact with other students or school staff during normal school activities,” he said.
Some exceptions, he said, would be activities like wrestling and similar sports.
“But I think the coaches and other school personnel are well aware of excluding kids who have rashes from participating in that type of activity,” he said.
The monkeypox virus can also be spread by touching contaminated objects, fabrics, and surfaces that have been used by someone with monkeypox, although CDC guidance says this route of transmission is less common during the current an epidemic.
The CDC also said that children, staff and volunteers generally should not be excluded from school, daycare or other settings if they have been exposed to monkeypox and do not have symptoms.
“I don’t think this can be emphasized enough,” Castell said, “but we really need to talk about monkeypox in a non-stigmatizing way and try to be fact-based in our discussions.”
The CDC’s guidance for schools and daycare centers reiterates its recommendations for the general public that people exposed to the monkeypox virus can continue their daily activities as long as they have no signs or symptoms of monkeypox.
In its guidance, the CDC said that in some cases involving high-risk exposure, the local health department may limit a person’s participation in certain activities.
In addition, boarding houses, overnight camps, and other housing settings must follow the agency’s guidelines for gathering living conditions.
Bloomberg said schools and daycares already have “robust” experience and policies in place for dealing with staff or children who are sick or potentially contagious, including those with a rash or fever that could indicate a contagious infection.
In addition, parents should monitor their children for symptoms before sending them to school or daycare.
“If your child is sick, they should stay home,” Castel said. Additionally, “if they develop a rash — which is common in children — one that may be accompanied by a fever, parents should contact their pediatrician or health care provider.”
Blumberg said clinicians can also help determine the cause of a child’s rash.
“If any parent or school staff is concerned about a rash that’s potentially monkeypox, they need to make sure it’s evaluated,” he said, “because there’s now widespread availability of testing.”
Overall, Castel thinks the CDC guidelines are “pretty comprehensive.” However, she would also like to see the information presented in a way that describes individual risks for different age groups.
“What a parent does with a young child in terms of prevention — helping them learn to wash their hands regularly and things like that — is different from [talking to] an adolescent or a student who may be involved in a close intimate relationship,” she said.
In addition, she urges parents to keep monkeypox in perspective as we head into fall.
“The risk of monkeypox [for children and adolescents] is very low right now,” she said, “but we also need to make sure kids are getting their routine childhood vaccinations — including polio, and hopefully soon the COVID boosters if they’re eligible.”
“This will help children be prepared and healthy as we begin this new school year,” she said.
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